Parental presence during resuscitation in the PICU: the parents' experience

Abstract

Aim and objective

To provide in-depth understanding of the meaning for parents who were present or absent during a resuscitation attempt on their child in the PICU.

Background

Family presence during resuscitation remains a topic of debate with both benefits and disadvantages identified, yet few studies have asked parents of children in PICU to describe their experiences of being present or absent during this resuscitation and what this means to their understanding and coping. Additionally, minimal research has investigated parental presence during a successful resuscitation.

Design

A qualitative design was used based upon van Manen's interpretative phenomenological approach.

Methods

Fourteen parents of critically ill children from one paediatric intensive care unit in Australia, who had either survived or died following a resuscitation attempt were interviewed.

Results

Four main themes were identified: (1) being only for a child; (2) making sense of a living nightmare; (3) maintaining hope in the face of reality; (4) living in a relationship with staff.

Conclusions

The findings underpin the inherent need for parents to choose to be present during resuscitation to make sense of the situation. Memories of the resuscitation were not long-lasting and distress was for the potential death of a child, rather than the resuscitation scene. Parents who did not witness their child's resuscitation were more distressed than those who did. Having the opportunity to make the decision to stay or leave was important for parents. Support during the resuscitation was best provided by experienced clinical nurses.

Relevance to practice

Recognition of the parents' compelling need to stay will improve nurses' understanding of how witnessing this event may assist family coping and functioning. Ways in which parents may be better supported in making the decision to stay or leave during resuscitation are identified.